背景:儿童存在多个有症状的肺结节和一个心脏肿瘤,需要紧急诊断和治疗。直到几十年前,心脏肿瘤的诊断是困难的,并且是基于间接体征的高度怀疑指数,并需要进行血管造影术确认。超声心动图和其他成像技术也有助于检测心脏肿瘤。然而,做出正确的诊断并不总是容易的。
方法:该病例是一名12岁男孩,有肺部症状,诊断出心脏肿瘤有肺转移.在我们医院证实了许多肺结节的存在。超声心动图检测到右心室有实性心脏结节。磁共振成像证实了这一发现和诊断。肺结节的穿刺抽吸可诊断为包虫病。他接受了心脏直视手术和心脏囊肿切除术,并接受了驱虫药治疗。然后切除了肺囊肿,他平安无事地康复了。
结论:这个孩子有多个肺结节和一个实性心脏结节,怀疑患有心脏肿瘤并有肺转移。然而,鉴于临床病史,肺结节的背景和形态,另一种可能的病因是包虫病。心脏包虫病及其并发症的临床表现变化很大。在这些病例中,临床病史是必不可少的,以及有很高的怀疑指数。
结论:包虫病应包括在鉴别诊断的固体,回声,心脏结节.心肺包虫囊肿的治疗是手术,其次是驱虫药。
BACKGROUND: The presence of multiple symptomatic pulmonary nodules and one cardiac tumour in a child requires urgent diagnosis and treatment. Until a few decades ago, the diagnosis of a cardiac tumour was difficult and was based on a high index of suspicion from indirect signs, and required angiocardiography for confirmation. Echocardiography and other imaging techniques have also helped in the detection of cardiac neoplasms. However, it is not always easy to make the correct diagnosis.
METHODS: The case is presented of a 12 year-old boy with pulmonary symptoms, and diagnosed with a cardiac tumour with lung metastases. The presence of numerous pulmonary nodules was confirmed in our hospital. The echocardiogram detected a solid cardiac nodule in the right ventricle. Magnetic resonance imaging confirmed the findings and the diagnosis. Puncture-aspiration of a lung nodule gave the diagnosis of hydatidosis. He underwent open-heart surgery with cardiac cyst resection and treated with anthelmintics. The lung cysts were then excised, and he recovered uneventfully.
CONCLUSIONS: This child had multiple pulmonary nodules and a solid cardiac nodule, and was suspected of having a cardiac tumour with pulmonary metastases. However, given the clinical history, background and morphology of pulmonary nodules, another possible aetiology for consideration is echinococcosis. The clinical picture of cardiac hydatidosis and its complications is highly variable. The clinical history is essential in these cases, as well as having a high index of suspicion.
CONCLUSIONS: Hydatidosis should be included in the differential diagnosis of a solid, echogenic, cardiac nodule. The treatment for cardiopulmonary hydatid cysts is surgical, followed by anthelmintics.